Maternal exposure to ozone and PM2.5 and the prevalence of orofacial clefts in four US states

• Type of Material: Article
• Authors: Yang Liu, Emory University; Ying Zhou, Emory University; Suzanne M. Gilboa, Centers for Disease Control and Prevention; Michele L. Herdt, New York State Department of Health; Philip J. Lupo, Baylor College of Medicine; W Dana Flanders, Emory University; Mikyong Shin, Centers for Disease Control and Prevention; Mark A. Canfield, Texas Department of State Health Services; Russell S. Kirby, University of South Florida
• Language: English
• Date: 2017-02-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016
• Final Published Version (URL): http://dx.doi.org/10.1016/j.envres.2016.11.007
• Title of Journal or Parent Work: Environmental Research
• ISSN: 0013-9351
• Volume: 153
• Start Page: 35
• End Page: 40
• Grant/Funding Information: Government funds were not used directly for this manuscript.
• Keywords: ORAL CLEFTS; Public, Environmental & Occupational Health; ASSOCIATION; Environmental Sciences & Ecology; Air pollution; Ozone; PM2.5; Cleft lip; RISK; METAANALYSIS; AMBIENT AIR-POLLUTION; LIP; Life Sciences & Biomedicine; CONGENITAL-ANOMALIES; BIRTH-DEFECTS; Cleft palate; UNITED-STATES; Environmental Sciences; Science & Technology; PALATE
• Research Categories: Health Sciences, Public Health; Environmental Sciences; Health Sciences, Epidemiology

Abstract

Background While there is some evidence that maternal exposure to ambient air pollution is associated with orofacial clefts in offspring, the epidemiologic studies have been largely equivocal. We evaluated whether maternal exposure to elevated county-level ambient fine particulate matter with aerodynamic diameter ≤2.5 µm (PM 2.5 ) and ozone during early gestation was associated with a higher prevalence of orofacial clefts. Methods Birth data consisting of 4.7 million births from 2001 to 2007 were obtained from National Birth Defects Prevention Network for four states — Arizona, Florida, New York (excluding New York City), and Texas. The air pollution exposure assessment for gestational weeks 5–10 was based on county-level average concentrations of PM 2.5 and ozone data generated using a Bayesian fusion model available through CDC's Environmental Public Health Tracking Network. Two outcomes were analyzed separately: cleft lip with or without cleft palate, cleft palate alone. In logistic regression analyses, we adjusted for factors that were suspected confounders or modifiers of the association between the prevalence of orofacial clefts and air pollution, i.e., infant sex, race-ethnicity, maternal education, smoking status during pregnancy, whether this was mother's first baby, maternal age. Results Each 10 µg/m 3 increase in PM 2.5 concentration was significantly associated with cleft palate alone (OR =1.43, 95% CI: 1.11–1.86). There was no significant association between PM 2.5 concentration and cleft lip with or without cleft palate. No associations were observed between ozone exposure and the two outcomes of orofacial clefts. Conclusions Our study suggests that PM 2.5 significantly increased the risk of cleft palate alone, but did not change the incidence of cleft lip with or without palate. Ozone levels did not correlate with incidence of orofacial clefts.